Organization
TREASURE VALLEY ANESTHESIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLE R SHAWVER CRNA (PRESIDENT)
(208) 604-0348
Entity
Organization
Contact information
Practice address
351 SW 9TH ST, ONTARIO, OR 97914
(541) 881-7140
Mailing address
24442 NUBIAN GOAT CT, CALDWELL, ID 83607-8525
(208) 604-0348
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006401000
REGENCE BCBSO
OR
05
—
276579
—
OR
05
—
805134400
—
ID
Enumeration date
04/18/2006
Last updated
07/08/2024
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